{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T18:48:23Z","timestamp":1769971703082,"version":"3.49.0"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P30CA006973"],"award-info":[{"award-number":["P30CA006973"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify molecular markers that predict advanced disease in mucin-producing cystic neoplasms of the pancreas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this single-institution study, 454 pancreatic cystic fluid specimens were examined by a clinical next-generation sequencing assay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>TP53 mutations were detected in 25 (7.9%) of 318 specimens harboring KRAS (BRAF or GNAS) mutation(s). Of the 25, 12 had advanced cytology\/histology (positive group), and 5 did not have advanced cytology\/histology (negative group). Eight cases were classified as indeterminate. Since KRAS and TP53 variant allele frequencies (VAFs) can be as low as 1% to 5%, we analyzed the TP53\/KRAS VAF ratio and demonstrated a significantly higher VAF ratio in the positive group (P\u2009=\u2009.005). A VAF ratio of 1 or higher, interpreted as an indicator of a dominant TP53 clone, and concurrent TP53, CDKN2A, and SMAD4 mutations were seen only in the positive group. Lower TP53 ratios, interpreted as a minor TP53 clone, were seen in all 5 negative group specimens.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These results suggest that VAF ratios and concurrent mutations can be incorporated into multimodality assessments of pancreatic cysts. Longitudinal studies in patients with a lower initial TP53 VAF ratio are warranted to elucidate whether serial VAF ratios are more accurate markers than a single VAF measurement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ajcp\/aqaf133","type":"journal-article","created":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T12:32:02Z","timestamp":1762777922000},"source":"Crossref","is-referenced-by-count":0,"title":["<i>TP53\/KRAS<\/i>\n                    variant allele frequency ratio predicts advanced disease in mucin-producing cystic neoplasms of the pancreas"],"prefix":"10.1093","volume":"165","author":[{"given":"Ming-Tseh","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University School of Medicine , Baltimore, MD, 21231,","place":["United 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Pathology, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University School of Medicine , Baltimore, MD, 21231,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Syed Z","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University School of Medicine , Baltimore, MD, 21231,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura D","family":"Wood","sequence":"additional","affiliation":[{"name":"Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University School of Medicine , Baltimore, MD, 21231,","place":["United States"]},{"name":"Department of Oncology, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University School of Medicine , Baltimore, MD, 21231,","place":["United 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